S AMDT 703

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H.R.1591 Making emergency supp
Sponsor: Jim|James DeMint (R) SC
 
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S 703 IS

111th CONGRESS

1st Session

S. 703

To provide for health care for every American and to control the cost and enhance the quality of the health care system.

IN THE SENATE OF THE UNITED STATES

March 25, 2009

Mr. SANDERS introduced the following bill; which was read twice and referred to the Committee on Finance


A BILL

To provide for health care for every American and to control the cost and enhance the quality of the health care system.

    Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title- This Act may be cited as the ‘American Health Security Act of 2009’.

    (b) Table of Contents- The table of contents of this Act is as follows:

      Sec. 1. Short title; table of contents.

TITLE I--ESTABLISHMENT OF A STATE-BASED AMERICAN HEALTH SECURITY PROGRAM; UNIVERSAL ENTITLEMENT; ENROLLMENT

      Sec. 101. Establishment of a State-based American Health Security Program.

      Sec. 102. Universal entitlement.

      Sec. 103. Enrollment.

      Sec. 104. Portability of benefits.

      Sec. 105. Effective date of benefits.

      Sec. 106. Relationship to existing Federal health programs.

TITLE II--COMPREHENSIVE BENEFITS, INCLUDING PREVENTIVE BENEFITS AND BENEFITS FOR LONG-TERM CARE

      Sec. 201. Comprehensive benefits.

      Sec. 202. Definitions relating to services.

      Sec. 203. Special rules for home and community-based long-term care services.

      Sec. 204. Exclusions and limitations.

      Sec. 205. Certification; quality review; plans of care.

TITLE III--PROVIDER PARTICIPATION

      Sec. 301. Provider participation and standards.

      Sec. 302. Qualifications for providers.

      Sec. 303. Qualifications for comprehensive health service organizations.

      Sec. 304. Limitation on certain physician referrals.

TITLE IV--ADMINISTRATION

Subtitle A--General Administrative Provisions

      Sec. 401. American Health Security Standards Board.

      Sec. 402. American Health Security Advisory Council.

      Sec. 403. Consultation with private entities.

      Sec. 404. State health security programs.

      Sec. 405. Complementary conduct of related health programs.

Subtitle B--Control Over Fraud and Abuse

      Sec. 411. Application of Federal sanctions to all fraud and abuse under American Health Security Program.

      Sec. 412. Requirements for operation of State health care fraud and abuse control units.

TITLE V--QUALITY ASSESSMENT

      Sec. 501. American Health Security Quality Council.

      Sec. 502. Development of certain methodologies, guidelines, and standards.

      Sec. 503. State quality review programs.

      Sec. 504. Elimination of utilization review programs; transition.

TITLE VI--HEALTH SECURITY BUDGET; PAYMENTS; COST CONTAINMENT MEASURES

Subtitle A--Budgeting and Payments to States

      Sec. 601. National health security budget.

      Sec. 602. Computation of individual and State capitation amounts.

      Sec. 603. State health security budgets.

      Sec. 604. Federal payments to States.

      Sec. 605. Account for health professional education expenditures.

Subtitle B--Payments by States to Providers

      Sec. 611. Payments to hospitals and other facility-based services for operating expenses on the basis of approved global budgets.

      Sec. 612. Payments to health care practitioners based on prospective fee schedule.

      Sec. 613. Payments to comprehensive health service organizations.

      Sec. 614. Payments for community-based primary health services.

      Sec. 615. Payments for prescription drugs.

      Sec. 616. Payments for approved devices and equipment.

      Sec. 617. Payments for other items and services.

      Sec. 618. Payment incentives for medically underserved areas.

      Sec. 619. Authority for alternative payment methodologies.

Subtitle C--Mandatory Assignment and Administrative Provisions

      Sec. 631. Mandatory assignment.

      Sec. 632. Procedures for reimbursement; appeals.

TITLE VII--PROMOTION OF PRIMARY HEALTH CARE; DEVELOPMENT OF HEALTH SERVICE CAPACITY; PROGRAMS TO ASSIST THE MEDICALLY UNDERSERVED

Subtitle A--Promotion and Expansion of Primary Care Professional Training

      Sec. 701. Role of Board; establishment of primary care professional output goals.

      Sec. 702. Establishment of Advisory Committee on Health Professional Education.

      Sec. 703. Grants for health professions education, nurse education, and the National Health Service Corps.

Subtitle B--Direct Health Care Delivery

      Sec. 711. Set-aside for public health.

      Sec. 712. Set-aside for primary health care delivery.

      Sec. 713. Primary care service expansion grants.

Subtitle C--Primary Care and Outcomes Research

      Sec. 721. Set-aside for outcomes research.

      Sec. 722. Office of Primary Care and Prevention Research.

Subtitle D--School-Related Health Services

      Sec. 731. Authorizations of appropriations.

      Sec. 732. Eligibility for development and operation grants.

      Sec. 733. Preferences.

      Sec. 734. Grants for development of projects.

      Sec. 735. Grants for operation of projects.

      Sec. 736. Federal administrative costs.

      Sec. 737. Definitions.

TITLE VIII--FINANCING PROVISIONS; AMERICAN HEALTH SECURITY TRUST FUND

      Sec. 800. Amendment of 1986 code; Section 15 not to apply.

Subtitle A--American Health Security Trust Fund

      Sec. 801. American Health Security Trust Fund.

Subtitle B--Taxes Based on Income and Wages

      Sec. 811. Payroll tax on employers.

      Sec. 812. Health care income tax.

TITLE IX--CONFORMING AMENDMENTS TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974

      Sec. 901. ERISA inapplicable to health coverage arrangements under State health security programs.

      Sec. 902. Exemption of State health security programs from ERISA preemption.

      Sec. 903. Prohibition of employee benefits duplicative of benefits under State health security programs; coordination in case of workers’ compensation.

      Sec. 904. Repeal of continuation coverage requirements under ERISA and certain other requirements relating to group health plans.

      Sec. 905. Effective date of title.

TITLE X--ADDITIONAL CONFORMING AMENDMENTS

      Sec. 1001. Repeal of certain provisions in Internal Revenue Code of 1986.

      Sec. 1002. Repeal of certain provisions in the Employee Retirement Income Security Act of 1974.

      Sec. 1003. Repeal of certain provisions in the Public Health Service Act and related provisions.

      Sec. 1004. Effective date of title.

TITLE I--ESTABLISHMENT OF A STATE-BASED AMERICAN HEALTH SECURITY PROGRAM; UNIVERSAL ENTITLEMENT; ENROLLMENT

SEC. 101. ESTABLISHMENT OF A STATE-BASED AMERICAN HEALTH SECURITY PROGRAM.

    (a) In General- There is hereby established in the United States a State-Based American Health Security Program to be administered by the individual States in accordance with Federal standards specified in, or established under, this Act.

    (b) State Health Security Programs- In order for a State to be eligible to receive payment under section 604, a State must establish a State health security program in accordance with this Act.

    (c) State Defined-

      (1) IN GENERAL- In this Act, subject to paragraph (2), the term ‘State’ means each of the 50 States and the District of Columbia.

      (2) ELECTION- If the Governor of Puerto Rico, the Virgin Islands, Guam, American Samoa, or the Northern Mariana Islands certifies to the President that the legislature of the Commonwealth or territory has enacted legislation desiring that the Commonwealth or territory be included as a State under the provisions of this Act, such Commonwealth or territory shall be included as a ‘State’ under this Act beginning January 1 of the first year beginning 90 days after the President receives the notification.

SEC. 102. UNIVERSAL ENTITLEMENT.


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